Why are we worried about measles in London?

The World Health Organisation reported an over 40-fold increase in measles cases in Europe last year. 

Over 30,000 cases of measles were reported across 40 countries in Europe last year, compared to less than 1,000 in the same area the year before. That’s a really dramatic increase and has doctors worried. 

Professor Dame Jenny Harries has raised the alarm in the UK and is concerned we are risking a larger outbreak without action. In the last month alone there have been over 150 cases in England, spread across many areas of the country. 

Does measles spread easily?

The reason the outbreak has health officials so worried is that measles spreads incredibly easily. 

It is much more infectious than Covid-19 for example. 

Up to 90% of people who are close to someone with measles will be infected, if they are not already immune.  

Measles is caused by a virus. It spreads easily through the air or by droplets, for example by coughing and sneezing. People with measles are infectious from the time their symptoms first appear until 4 days after the appearance of the rash. So often for up to a week in total. 

What are the symptoms of measles?

Measles infection is caused by a virus and the symptoms often start like any other virus. These can include fever, tiredness, runny nose, cough and conjunctivitis (redness of the eyes). Then a rash starts to appear. This is unusual in that it starts on the head or face and then spreads down the body and to the arms and legs over 3 to 4 days. The rash is pink, with flat or slightly raised spots. 

Koplik’s spots are a special sign we would always look for if we suspect a measles infection. These are red spots with a blue or whitish centre that can be seen inside the mouth. They appear one to two days before the rash appears and can still be seen for 1 to 2 days afterward. 

If you are concerned about the possibility of measles then please contact your healthcare provider as soon as possible. This means you can get treatment advice and be monitored for any complications. If measles is suspected your doctor should make arrangements for you to have tests to confirm the infection. It will also help track outbreaks and we can vaccinate people who you have been in contact with too to reduce the chances of them becoming unwell. 

Do I need a measles vaccine?

We would recommend everyone who is fully vaccinated to protect themselves and their loved ones against measles. Two doses of the vaccine will provide over 99% protection. There are a small number of people who can not have the vaccination for health reasons, such as an allergy to part of the vaccine or immunosuppression (having a very low immune system). 

If you or your child have been exposed to someone with measles and have not been fully vaccinated you may be given the MMR vaccine which may prevent an infection. This is most effective if given within 3 days of exposure so don’t delay if you have been exposed. It is very safe to give the vaccine even if you might already be incubating measles. Many people are not sure if they were vaccinated in children or don’t have access to their records, in this scenario it is safe to have an extra dose of the vaccine. 

What age can babies and children be vaccinated against measles?

MMR (measles, mumps and rubella) vaccine is given at 12 months of age and again at 3 years and 4 months of age (often called ‘preschool booster’), as part of the routine childhood vaccination schedule in the UK. 

If a young baby or child is at an increased risk of measles the vaccine can be given earlier. This is usually if they have been exposed to someone with measles or are traveling to an area where there is a measles outbreak.

Babies under 1 year of age: they can have the vaccine from 6 months of age. At this young age, many babies will still have antibodies from their mother which were passed over during pregnancy across the placenta. This means the vaccine may not be as effective. If a baby has a dose of the MMR vaccine under 12 months of age, we would still recommend they have their two further routine doses to make sure they are well protected. 

Children aged 1 to 5: Some babies will not be immune after their first dose of MMR vaccine. This is why a second dose of the vaccine is recommended, usually at preschool age, 3 years and 4 months onwards. The second dose of the vaccine can be given safely from 18 months of age. It has been given in this way in many countries to ensure young children receive full protection sooner. In the current outbreak, parents may wish to give their children the second dose of the MMR vaccine from 18 months of age and we would support this as a sensible choice. 

If the child is over 3 years and 4 months of age and has not yet had their preschool booster this should be done as soon as possible. 

Children aged 5 to 18 years of age: any child who might have missed one or both doses of the MMR vaccine during their childhood should be vaccinated as soon as possible. If they have missed both doses they can receive each dose 1 month apart.  

Adults of any age: 

If you have not had two doses of the MMR vaccine this is highly recommended. 

Born between 1980 and 1990 in the UK? Many people in this age bracket only received one dose of the MMR vaccine in childhood. They should definitely receive their second dose now. 

Born between 1970 and 1979 in the UK? You might have received a measles vaccine in childhood. We can safely give two doses of the MMR vaccine. This is especially recommended if you are at a high risk of being exposed to measles or if we know you are not immune. 

Born in the UK before 1970? There is a good chance you may have had measles or been exposed to the virus in childhood and be immune. We can do a blood test to check for immunity if needed or vaccinate you. 

Help protect more people by sharing this with family and friends. 

Dr Lucy Coyne

Coyne Medical